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Using Computer Simulation to Study Nurse-to-Patient Ratios in an Emergency Department

Henneman, Philip L. MD; Shin, Seung Yeob MS; Brun, Yuriy PhD; Balasubramanian, Hari PhD; Blank, Fidela MN, MBA, RN; Osterweil, Leon J. PhD

Journal of Nursing Administration: November 2015 - Volume 45 - Issue 11 - p 551–556
doi: 10.1097/NNA.0000000000000262
Articles

OBJECTIVE: To study the impact of nurse-to-patient ratios on patient length of stay (LOS) in computer simulations of emergency department (ED) care.

METHODS: Multiple 24-hour computer simulations of emergency care were used to evaluate the impact of different minimum nurse-to-patient ratios related to ED LOS, which is composed of wait (arrival to bed placement) and bedtime (bed placement to leave bed).

RESULTS: Increasing the number of patients per nurse resulted in increased ED LOS. Mean bedtimes in minutes were impacted by nurse-to-patient ratios.

CONCLUSIONS: In computer simulation of ED care, increasing the number of patients per nurse resulted in increasing delays in care (ie, increasing bedtime).

Author Affiliations: Professor and Attending Physician (Dr Henneman) and Assistant Professor and Nurse Research Coordinator (Ms Blank), Department of Emergency Medicine at Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts; PhD Candidate (Mr Shin) and Assistant Professor (Dr Brun), School of Computer Science, and Associate Professor (Dr Balasubramanian), College of Engineering, University of Massachusetts, Amherst; and Professor (Dr Osterweil), School of Computer Science, University of Massachusetts, Amherst.

This research was partially supported by the US National Science Foundation under awards IIS-1239334 and CNS-1258588 and the National Institute of Standards and Technology under grant 60NANB13D165.

The authors declare no conflicts of interest.

Correspondence: Dr Henneman, 109 Lake Ave, Sunapee, NH 03782 (philip.henneman@bhs.org).

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